Neural symptoms induced by tricyclic antidepressants: phenomenology and pathophysiology

The authors review the literature describing the neural symptoms induced by tricyclic antidepressants, especially tremor, seizures, akathisia, myoclonus, dyskinesia and delirium. Sedation, modifications of sleep, memory and appetite are also described. Tremor and myoclonus are the most frequent drug-induced neural symptoms. Delirium is most often caused by high-dosage treatments. The pathophysiology of akathisia and dyskinesia raises important questions concerning the mode of action of antidepressants.